Ectopic Pregnancies Could Lower Chances of a Big Family

Ectopic pregnancy could mean fewer children and more at risk pregnancies

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Did you know that ectopic pregnancies could lower future chances for achieving a live birth? Ectopic pregnancies may affect women's fertility more than other childbirth issues.

A new study has found that, over a 20 to 30 year time period, women who experience an ectopic pregnancy during their first pregnancy will potentially end up having fewer children than women whose first pregnancy ends in a delivery, miscarriage or abortion.

"Talk to your doctor about options for fertility treatments."

Ectopic pregnancy occurs when a fertilized egg implants itself somewhere in the body other than the womb -- typically, in one of the fallopian tubes.

The study, conducted at the Gynecological Clinic at the Rigshospitalet in Copenhagen, Denmark, was the first study to look at long-term reproductive outcomes in women whose first pregnancy was ectopic.

About one percent of pregnancies turn out to be ectopic. The zygote typically dies so these pregnancies never end with childbirth. Women who suffer these pregnancies are either given a drug called methotrexate so the pregnancy tissue can absorb into the body or they undergo surgery.

Previous medical data has shown that ectopic pregnancy can significantly increase the risk of experiencing another one, however most studies on this issue have been small and short. Researchers gathered data on around 3,000 women from four Danish registries recorded during 1977-2009. 

These women were then matched up with other women of the same age whose first pregnancy had resulted in a delivery, miscarriage or abortion. The ectopic group was also compared with a fourth group of women who had not experienced a pregnancy in the same years.

The results showed that the group of women who had ectopic pregnancies during their first pregnancy had the lowest delivery rate for later pregnancies, the lowest total number of pregnancies over the observed 20 to 30 years, as well as lower rates of miscarriages and abortions.

Women who had experienced ectopic pregnancy were found to have had a rate of 69 deliveries per 100 women -- the lowest long-term rate of deliveries.

Also for future pregnancies, women who experienced a miscarriage during their first pregnancy showed a rate of 126 deliveries per 100 women, women who had an abortion showed 77 deliveries per 100 women and women who delivered showed a rate of 73 deliveries per 100 women.

Comparatively, women who had experienced a miscarriage during their first pregnancy were twice as likely to have a future pregnancy end in delivery; women whose first pregnancy had ended in a delivery were found to basically have the same rate of future deliveries.

Doctors suggest that this statistical lack of difference was not surprising, and argued that women with previous ectopic issues were more likely to try harder to have the number of children they wanted, and that these numerous attempts were most likely counterbalanced by their lowered fertility.

When compared to the abortion group, the ectopic group saw an 11 percent reduction in future delivery rates, and compared to the not pregnant in the same year group, the ectopic group saw a 31 percent reduction.

Dr. Line Lund Kårhus, MD, a research student in the Gynecological Clinic, stated that, "These results indicate that fertility is compromised in women whose first pregnancy is ectopic and even after 30 years, they have significantly fewer children compared with other women.

She also said that the research team expected women to compensate over time for their lowered fertility by trying to get pregnant more often. However, findings reveal that, compared to other women, the extra attempts at pregnancy do not result in the same number of babies for women who had experienced an ectopic pregnancy during their first pregnancy.

Interestingly, the study also found that, compared to the women in the miscarriage group, women in the ectopic group were less likely to have a miscarriage in future pregnancies by 54 percent, and were also less likely to have an abortion in future pregnancies by 28 percent.

Ultimately, the research team asserts that better assisted reproductive techniques have been developed in the recent years and the possible improvements of such technology were not accounted for in the study. Due to this, they say the ectopic inquiry is still under current investigation.

This study was conducted in Copenhagen, Denmark and published online on October 17 in Human Reproduction. 

Reviewed by: 
Review Date: 
November 14, 2012
Last Updated:
November 16, 2012